When you enroll into government Medicare Part A & B, you might assume that you are also enrolling into Part D. Oh, if it were that easy. Medicare Part D is prescription coverage and you can only enroll through a private insurance company.
Most of our clients are taking a few cheap, generic drugs. Many of them are cheaper without using their drug insurance at Walmart or Meijer. So, why pay for a Part D drug plan when you are not using it? When every little bit of savings helps, why pay that monthly premium?
You may be healthy now, but right around the corner you may be prescribed some of the most expensive drugs on the market that are widely used by Medicare beneficiaries: Eliquis is the most popular blood thinner. The average retail price without insurance is $700 per month.
“Sure but if I do get sick, I can always get a drug plan every year during the open enrollment period October to December.” Correct, but you’ll also have to pay a lifetime penalty for every month that you were ELIGIBLE for Medicare Part D but failed to enroll and didn’t have creditable coverage through an employer’s work insurance.
2024 saw Medicare Part D plans with prices from $0 to $10 per month in all areas. The monthly savings on premium isn’t helping your budget.
People have insurance fatigue. Even though it isn’t expensive to purchase a drug plan, just in case you’ll need it eventually and to avoid the penalty, people still are reluctant to enroll. Too much insurance. Too many decisions. Especially if they are not taking any medications at all.
And some people are just stubborn. They are healthy and fervently plan to stay healthy, so why jinx it by purchasing insurance they don’t need? I’ve heard it all since 2005 when the Medicare Part D drug benefit began. And unfortunately, I’ve had to take those desperate calls when a client gets a diagnosis and needs a drug plan NOW. Now is almost never an option.
Worst case scenario, you get Crohn’s disease, rheumatoid arthritis, or ulcerative colitis. You need REMICADE. The cost can be $3,000 to $12,000 per treatment. An annual cost of $50,000 to $150,000.
Buy a Medicare Part D drug plan and hope you don’t need it. It isn’t expensive and there are cheap plans that get you in the program and prevent a late penalty from accruing. Later, when you need specific drugs, you can change to a better plan to fit your needs.
If you are not yet at the age for Medicare but are getting nervous about the program, you can go to medicare.gov and play around with the drug calculator. Put in the list of your medications, and you can get a feel what your Rx will cost on Medicare. It will no doubt be higher each year, but at least you get an idea of the current prices.
Sylvia Gordon is co-founder of The Medicare Family, headquartered in Noblesville, where she educates thousands on Medicare and Social Security in all 50 states. You can learn more at TheMedicareFamily.com.